Athletes swallowing performance-enhancing drugs are swallowing a time bomb, Canada's chief antidoping official says.

Victor Lachance, head of the Canadian Centre for Ethics in Sport, said he is not surprised that authorities in Italy and Britain are studying the premature deaths of soccer players from Lou Gehrig's disease, suspecting a connection to medications they were given by their clubs or took themselves.

"It's not unreasonable to speculate or suspect that drug use is linked to the deaths of [the soccer] athletes, given the wide range of drugs used for doping substances and given that a combination of them could create symptoms that mimic known diseases or actually cause damage in the brain," Lachance said.

At least 40 cases of Lou Gehrig's disease -- a chronic, progressive and fatal neurological disease medically known as amyotrophic lateral sclerosis or ALS -- have come under the magnifying glass of Italy's top antidrug magistrate, Raffaele Guariniello of Turin.

In a normal population of 24,000 -- the number of soccer players in Italy's Serie A and Serie B from 1960-1997 -- doctors might encounter a single case of the disease. Finding 40 cases among that number of players is "terrifying," Guariniello told reporters.

The high incidence "appears to be work related," he said. Guariniello suspects a link to the use of painkillers, particularly corticosteroids, which enable players to take the field in spite of injury.

In Britain, the governing Football Association has also begun to investigate the deaths of several players with the disease, including Don Revie, Rob Hindmarch and Willie Maddren. Former Celtic winger Jimmy Johnstone is seriously ill with ALS, while former London Irish rugby player Jarrod Cunningham was diagnosed with the condition in the fall.

Italy's big-name fatality is Gianluca Signorini, the classy defender for Parma, Genoa and Roma who died 12 weeks ago. When Guariniello started interviewing dying players last March, Signorini's wife, Antonella, refused to place any blame.

"Maybe it is only the fruit of destiny," she said. "We are accusing no one. Gianluca has said to me so many times: no one ever administered drugs to him against his will."

Guariniello staged a previous study into premature deaths among professional cyclists. He found a higher-than-normal rate of cancers of the liver and stomach, which could be linked to the use of steroids. He also found such cancers among soccer players who died young.

Lachance said the long-term consequences of drug use by athletes will only be unveiled over time because such drug use is clandestine and it would be unethical for doctors to generate their own clinical information by giving subjects the quantities and combinations of drugs some athletes reportedly use.

"We really are operating in the dark about when and how the health consequences will show up," Lachance said. "We know they will, because many of the doping substances have been studied for medical usage and side effects can show up even with small doses. We can predict far worse side effects in non-medical applications."

The high incidence of ALS among soccer players is the only hard evidence investigators have to go on, so far. The connection between Lou Gehrig's disease and drug use is more of a gut feeling.

The mystery is compounded by the fact investigators can't get precise information on the medications athletes have taken, and doctors do not know the exact cause of Lou Gehrig's disease.